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1. Impact of ultrasound speed choice on the quality of the second-trimester fetal ultrasound examination in obese women

Author

B. Chauveau, Lemlih Ouchchane, N. Salesse, Didier Lémery, A. Delabaere, Anne Debost-Legrand, A. Puissegur, Thérapie guidée par l'image (TGI), Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Sigma CLERMONT (Sigma CLERMONT)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Faculté de Médecine - Clermont-Auvergne (FM - UCA), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), and SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])

Subjects
Adult, medicine.medical_specialty, prenatal, Pregnancy trimester, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Ultrasonography, Prenatal, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Second trimester, Gestational Weeks, Ultrasound propagation velocity, Image quality, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Obesity, ComputingMilieux_MISCELLANEOUS, Ultrasound image, Ultrasonography, Retrospective Studies, 2. Zero hunger, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Fetus, Radiological and Ultrasound Technology, business.industry, Ultrasound, Gestational age, Mean age, General Medicine, second, Cross-Sectional Studies, Pregnancy Trimester, Second, 030220 oncology & carcinogenesis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Radiology, business, Body mass index, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Purpose The purpose of this study was to assess the impact of the free choice of ultrasound propagation velocity on ultrasound image construction to improve the completion rate and anatomical quality of fetal second-trimester ultrasound examination in obese women. Materials and methods This repeated cross-sectional single-center study retrospectively collected second-trimester ultrasound images of 88 obese women. During the first period, ultrasound examinations were performed in 44 women (mean age, 31.4 ± 5.9 [SD] years; range: 21.1 - 45.3 years) applying only the standard 1540 m/s tissue ultrasound velocity (group 1). During the second period, ultrasound examinations were performed in other 44 women (mean age, 31.4 ± 5.1 [SD] years; range: 20.6 - 41.6 years) with the operator free to choose among three available velocity settings (1420 m/s, 1480 m/s or 1540 m/s) for the scanning planes for the morphological images (group 2). All women underwent mid-trimester ultrasound examination at 20 to 24 gestational weeks. Two observers assessed the examinations in both groups for completeness, quality, and duration of fetal ultrasound examinations. Results No differences in age (P > 0.99), body mass index (P = 0.67), prevalence of previous cesarean delivery (P = 0.30) or gestational age at the second-trimester scan (P = 0.20) were found between the two groups. The mean cumulative duration of these ultrasound examinations was longer in group 1 than in group 2 (for both the complete (P = 0.04) and incomplete (P = 0.03) examinations). The quality of the anatomic images according to Salomon's criteria was less often acceptable in group 1 (5/44, 11.4%) than in group 2 (15/44, 34.1%) (P = 0.02). Conclusion Free choice of ultrasound velocity improves the overall performance of fetal second-trimester ultrasound examinations in obese women.

Published
2021
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2. Success to reach 3cm of dilation with a Dinoprostone Vaginal Insert in primiparous women with a previous cesarean section versus nulliparous: A retrospective case-control study

Author

Aurélie Comptour, Amélie Delabaere, Camille Huret, Laurent Ouziel, Sylvie Ughetto, Bruno Pereira, Denis Gallot, Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Service Obstétrique [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Clermont-Ferrand

Subjects
Reproductive Medicine, Cesarean Section, Pregnancy, Case-Control Studies, Humans, Obstetrics and Gynecology, Female, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Dilatation, Dinoprostone, Cervical Ripening, Retrospective Studies
Abstract

Background The best methods of labour induction have still been controversial because of an increased risk of uterine rupture, especially in exposed women of labour induction with prostaglandins. We here attempted to determine, after Dinoprostone Vaginal Insert, previous cesarean women (exposed women), compared with nulliparous women (non-exposed women), are more likely 1) to have the dilated cervix (up to 3 cm or more), and 2) to require cesarean after cervix being dilated 3 cm or more. Methods This retrospective observational study included 43 exposed women and 188 non exposed women . A propensity score was calculated to balance the background differences including age, BMI, Bishop. Main findings Exposed women were significantly less likely to reach 3 cm of cervix dilation than non exposed women (62.8 and 67.6% [study] vs. 83 and 81.3% [control] before and after propensy score analysis, respectively (p0.05)). However exposed women were significantly less likely to require cesarean than non exposed women (4.9 vs. 17.2% p = 0.03) after inverse probability of treatment weighting once 3 cm dilation was reached. Conclusion After Dinoprostone Vaginal Insert, women with scarred uterus were less likely to reach 3 cm of cervix dilation but once 3 cm of dilation was achieved, they were less likely to require cesarean.

Published
2022
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3. Factors associated to early intrauterine fetal demise after laser for TTTS by preoperative fetal heart and Doppler ultrasound

Author

Delabaere, Amélie, Delabaere, Amelie, Leduc, France, Reboul, Quentin, Fuchs, Florent, Wavrant, Sandrine, Dubé, Johanne, Fouron, Jean-Claude, Audibert, François, Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre hospitalier universitaire Sainte-Justine [Montréal, Canada], Département d'Obstétrique Gynécologie, Université de Montréal (UdeM)-CHU Sainte Justine [Montréal], SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and CHU Sainte Justine [Montréal]

Subjects
Adult, medicine.medical_specialty, medicine.medical_treatment, Cardiomyopathy, Hemodynamics, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Ultrasonography, Prenatal, Fetoscopy, 03 medical and health sciences, Fetal Heart, 0302 clinical medicine, Pregnancy, medicine.artery, Internal medicine, medicine, Humans, 030212 general & internal medicine, Fetal Death, ComputingMilieux_MISCELLANEOUS, Genetics (clinical), Retrospective Studies, Fetus, Laser Coagulation, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Quebec, Obstetrics and Gynecology, Umbilical artery, Fetofetal Transfusion, Twins, Monozygotic, medicine.disease, Echocardiography, Doppler, 3. Good health, Middle cerebral artery, Pregnancy, Twin, Cardiology, Female, business, Laser coagulation, Ductus venosus
Abstract

Objective To determine the prognostic value of fetal Doppler and echocardiographic parameters for intrauterine fetal demise (IUFD) within 24 hours and within 1 week after laser coagulation in monochorionic pregnancies complicated by twin-twin transfusion syndrome. Method This retrospective study correlated the preoperative hemodynamic and echocardiography parameters to the outcome in fetuses with twin-twin transfusion syndrome undergoing laser therapy. Results One hundred and twelve laser coagulations were performed between February 2006 and June 2015. The total (single and double) IUFD rate was 27.7%. Further, 59% of IUFD occurred within 24 hours and 74.4% occurred within 1 week after laser. The following were associated to IUFD within 24 hours: the middle cerebral arterial pulsatility index in the donor, abnormal umbilical artery (UA) end diastolic flow, increased middle cerebral artery peak systolic velocity, and right ventricular myocardial performance index (RV-MPI) z-score in the recipient. For IUFD within 1 week were the pulsatility index in the donor UA and the recipient abnormalities in UA, ductus venosus, middle cerebral artery-peak systolic velocity, and RV-MPI z-score. Conclusion Following laser was early IUFD that was associated with Doppler findings suggesting donor cerebroplacental redistribution, and recipient overload cardiomyopathy, such as abnormal ductus venosus and UA Dopplers as well as an increase of RV-MPI.

Published
2018
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4. Retinoic acid and tracheal occlusion for diaphragmatic hernia treatment in rabbit fetuses

Author

Delabaere, Amélie, Delabaere, Amelie, Blanchon, Loïc, Coste, Karen, Clairefond, Gael, Belville, Corinne, Blanc, Pierre, Marceau, Geoffroy, Sapin, Vincent, Gallot, Denis, Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Retinoids, Development and Developmental Diseases (R2D2), Université d'Auvergne - Clermont-Ferrand I (UdA), Génétique, Reproduction et Développement (GReD), Chercheur indépendant, Laoratoire de Biochimie, CHU Clermont-Ferrand, Laboratoire de Biochimie, Pôle Entrepreneuriat et Innovation - Rouen Business School, Rouen Business School, SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Faculté de Médecine - Clermont-Auvergne (FM - UCA), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Université de Clermont-Ferrand, Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015 - 2019) (COMUE UCA), and Centre Hospitalier Universitaire de Clermont-Ferrand

Subjects
Pathology, medicine.medical_specialty, Side effect, Retinoic acid, Connective tissue, Antineoplastic Agents, Apoptosis, Tretinoin, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.BDLR.RS]Life Sciences [q-bio]/Reproductive Biology/Sexual reproduction, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Pregnancy, 030225 pediatrics, medicine, Animals, Diaphragmatic hernia, Lung, ComputingMilieux_MISCELLANEOUS, Genetics (clinical), Hernia, Diaphragmatic, Fetus, business.industry, Fetoscopy, Obstetrics and Gynecology, Congenital diaphragmatic hernia, Pulmonary Surfactants, Histology, respiratory system, medicine.disease, Elastin, 3. Good health, Trachea, Fetal Diseases, medicine.anatomical_structure, chemistry, 030220 oncology & carcinogenesis, Female, Collagen, Rabbits, business
Abstract

INTRODUCTION Lung hypoplasia and pulmonary arterial hypertension in congenital diaphragmatic hernia lead to a high perinatal mortality. Although sustained fetoscopic tracheal occlusion (TO) improves lung development, a major side effect is abnormal pneumocyte differentiation. This study evaluated the potential ability of intratracheal retinoic acid (RA) administration to reduce adverse effects of sustained TO in a rabbit model of diaphragmatic hernia. METHODS A left diaphragmatic defect was created on day 23 in time-dated pregnant rabbits. On day 28, the same rabbits underwent sham surgery or TO, with an injection of empty or RA-loaded liposomes. On day 30, the fetuses were harvested, and the lungs were processed for histology, immunohistochemistry, and gene expression quantification. RESULTS A tracheal RA injection at the time of TO had no effect on the lung-to-body-weight ratio, radial alveolar count or lung connective tissue composition. Retinoic acid plus TO had synergic effects on vascular measurements, proportional medial thickness, and endothelin-1 receptor type-A gene expression. The most noticeable effect was recovery of normal pneumocyte differentiation. CONCLUSION Retinoic acid plus TO prevented abnormal pneumocyte differentiation and seemed to have a beneficial effect on pulmonary vascularization.

Published
2018
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5. Laryngotracheoesophageal cleft, a rare differential diagnosis of esophageal atresia

Author

Delabaere, Amélie, Bruhat, Clément, Briac, Thierry, Delabaere, Amelie, Labbé, André, Lémery, Didier, Laurichesse-Delmas, Hélène, Gallot, Denis, Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Clermont-Ferrand, Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Gynécologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Pôle Entrepreneuriat et Innovation - Rouen Business School, and Rouen Business School

Subjects
Adult, Polyhydramnios, Larynx, [SDV]Life Sciences [q-bio], Prenatal diagnosis, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Ultrasonography, Prenatal, Congenital Abnormalities, Diagnosis, Differential, 03 medical and health sciences, Esophagus, 0302 clinical medicine, Pregnancy, Pathognomonic, medicine, Humans, 030212 general & internal medicine, Esophageal Atresia, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, Anatomy, Laryngeal cleft, medicine.disease, Trachea, medicine.anatomical_structure, Reproductive Medicine, Atresia, Female, Differential diagnosis, medicine.symptom, Pouch, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

A laryngotracheoesophageal cleft, commonly called laryngeal cleft (LC), is a congenital malformation of the posterior part of the larynx creating an abnormal communication between the laryngotracheal axis and the pharyngoesophageal axis. The prenatal ultrasonographic features associating absent stomach, polyhydramnios and mediastinal "pouch sign" are usually considered pathognomonic for esophageal atresia. This observation demonstrates that they can also correspond to a severe form of laryngotracheoesophageal cleft extending to the carina.

Published
2018
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6. A novel assistive method for rigidity evaluation during deep brain stimulation surgery using acceleration sensors

Author

Erik Schkommodau, Jean-Jacques Lemaire, Philippe Derost, Ashesh Shah, Jerome Coste, Raphael Guzman, Ethan Taub, Simone Hemm, Institute for Medical and Analytical Technologies, School of Life Sciences (IMA), University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Neurochirurgie [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Departments of Neurosurgery and Biomedicine, University Hospital Basel [Basel], Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de Neurologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU de Clermont-Ferrand, Université Clermont Auvergne, Institut Pascal, Apport de l'accélérométrie à la stimulation cérébrale - 2011-A00774-37 - CHU de Clermont-Ferrand, Thérapie guidée par l'image (TGI), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), This research was funded by the Swiss National Science Foundation as a part of the project205321_135285 and partly by the Germaine de Stael program of the Swiss Academy ofEngineering Sciences. We acknowledge and thank Prof. F. Durif, Dr. M. Ulla, and Dr. A.Marques of the Department of Neurology at the CHU Clermont-Ferrand, France, and Ms. BiancaRaffaelli and Prof. Dr. Peter Fuhr of the Department of Neurology at the University Hospital ofBasel, Switzerland, for performing the routine passive movements for rigidity evaluations.The clinical use of the afore-described data-recording system for the purpose of intraoperativeand postoperative symptom evaluation in the framework of this study was approved by theinstitutional review boards of the University Hospital in Clermont-Ferrand (France) and theUniversity Hospital of Basel (Switzerland)., CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de Neurochirurgie [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Deep brain stimulation, Movement disorders, Parkinson's disease, medicine.medical_treatment, fields of Forel, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Deep Brain Stimulation, Movement, 0206 medical engineering, Stimulation, Rigidity (psychology), 02 engineering and technology, Wrist, Accelerometer, Neurosurgical Procedures, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Humans, Electrodes, functional neurosurgery, Aged, subthalamic nucleus, business.industry, Parkinson Disease, General Medicine, Middle Aged, medicine.disease, 020601 biomedical engineering, quantification, Muscle Rigidity, Subthalamic nucleus, medicine.anatomical_structure, rigidity, Physical therapy, acceleration sensor, intraoperative, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

OBJECTIVEDespite the widespread use of deep brain stimulation (DBS) for movement disorders such as Parkinson's disease (PD), the exact anatomical target responsible for the therapeutic effect is still a subject of research. Intraoperative stimulation tests by experts consist of performing passive movements of the patient's arm or wrist while the amplitude of the stimulation current is increased. At each position, the amplitude that best alleviates rigidity is identified. Intrarater and interrater variations due to the subjective and semiquantitative nature of such evaluations have been reported. The aim of the present study was to evaluate the use of an acceleration sensor attached to the evaluator's wrist to assess the change in rigidity, hypothesizing that such a change will alter the speed of the passive movements. Furthermore, the combined analysis of such quantitative results with anatomy would generate a more reproducible description of the most effective stimulation sites.METHODSTo test the reliability of the method, it was applied during postoperative follow-up examinations of 3 patients. To study the feasibility of intraoperative use, it was used during 9 bilateral DBS operations in patients suffering from PD. Changes in rigidity were calculated by extracting relevant outcome measures from the accelerometer data. These values were used to identify rigidity-suppressing stimulation current amplitudes, which were statistically compared with the amplitudes identified by the neurologist. Positions for the chronic DBS lead implantation that would have been chosen based on the acceleration data were compared with clinical choices. The data were also analyzed with respect to the anatomical location of the stimulating electrode.RESULTSOutcome measures extracted from the accelerometer data were reproducible for the same evaluator, thus providing a reliable assessment of rigidity changes during intraoperative stimulation tests. Of the 188 stimulation sites analyzed, the number of sites where rigidity-suppressing amplitudes were found increased from 144 to 170 when the accelerometer evaluations were considered. In general, rigidity release could be observed at significantly lower amplitudes with accelerometer evaluation (mean 0.9 ± 0.6 mA) than with subjective evaluation (mean 1.4 ± 0.6 mA) (p < 0.001). Of 14 choices for the implant location of the DBS lead, only 2 were the same for acceleration-based and subjective evaluations. The comparison across anatomical locations showed that stimulation in the fields of Forel ameliorates rigidity at similar amplitudes as stimulation in the subthalamic nucleus, but with fewer side effects.CONCLUSIONSThis article describes and validates a new assistive method for assessing rigidity with acceleration sensors during intraoperative stimulation tests in DBS procedures. The initial results indicate that the proposed method may be a clinically useful aid for optimal DBS lead placement as well as a new tool in the ongoing scientific search for the optimal DBS target for PD.

Published
2016
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7. Aortic Isthmus Flow Recording Predicts the Outcome of the Recipient Twin after Laser Coagulation in Twin-Twin Transfusion Syndrome

Author

Delabaere, Amélie, Leduc, France, Delabaere, Amelie, Gendron, Roxanne, Fuchs, Florent, Wavrant, Sandrine, Raboisson, Marie-Josée, Fouron, Jean-Claude, Audibert, François, Thérapie guidée par l'image (TGI), Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS)-Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Centre de recherche en épidémiologie et santé des populations (CESP), Hôpital Paul Brousse-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre hospitalier universitaire Sainte-Justine [Montréal, Canada], Département d'Obstétrique Gynécologie, Université de Montréal (UdeM)-CHU Sainte Justine [Montréal], Sigma CLERMONT (Sigma CLERMONT)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Sigma CLERMONT (Sigma CLERMONT)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Sigma CLERMONT (Sigma CLERMONT)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Sainte Justine [Montréal], SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
Embryology, medicine.medical_specialty, animal structures, medicine.medical_treatment, Twins, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, 0302 clinical medicine, Laser therapy, Predictive Value of Tests, Pregnancy, Medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Fetal Death, Twin Twin Transfusion Syndrome, ComputingMilieux_MISCELLANEOUS, Aorta, 030219 obstetrics & reproductive medicine, Laser Coagulation, urogenital system, business.industry, Fetoscopy, Obstetrics and Gynecology, General Medicine, Fetofetal Transfusion, Laser Doppler velocimetry, Echocardiography, Doppler, Surgery, Treatment Outcome, embryonic structures, Pediatrics, Perinatology and Child Health, cardiovascular system, Aortic isthmus, Female, business, Laser coagulation, Blood Flow Velocity
Abstract

Introduction: The objective was to assess the prognostic value of the systolic flow through the aortic isthmus in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS) treated by placental laser ablation. Material and Methods: Fetal echocardiography and outcome data of 105 cases of TTTS treated by laser photocoagulation of placental anastomoses were reviewed. Hemodynamic parameters were collected before and after treatment. The isthmic systolic index (ISI) was calculated as the peak systolic velocity/systolic nadir ratio. Results: A total of 105 laser coagulations were studied. Fetal echocardiography pre- and post-laser were available in 68 cases, including 55 with data on aortic isthmic Doppler. Survival rates were 17, 22, and 61% for 0, 1, or 2 twins, respectively. At least 1 twin was delivered alive in 83% of the pregnancies. The mean gestational age at surgery was 21 weeks (range 16-26). Median ISI values were similar for donor and recipient twins, before and after laser ablation (all p > 0.05). A lower recipient ISI before laser was related to early recipient demise within 24 h (p = 0.04). Discussion: A lower ISI before placental laser ablation for TTTS is associated with postoperative demise of the recipient twin.

Published
2016
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8. Syntélencéphalie et monosomie 21q partielle

Author

Amélie Delabaere, A. Tran Mau-Them, Didier Lémery, H. Laurichesse-Delmas, Denis Gallot, Carole Goumy, Thérapie guidée par l'image (TGI), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement (GReD ), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)

Subjects
Reproductive Medicine, Obstetrics and Gynecology, General Medicine, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Biology, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2015
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